Organization Active NPI

Okemah Chiropractic Clinic Inc PC

  • Chiropractor
  • Okemah, OK
National Provider Identifier
1003990185
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3578 Issued in OK
Legal business name
OKEMAH CHIROPRACTIC CLINIC INC PC
Practice address
1003 W Broadway
Okemah, OK 74859
Phone
(918) 623-0613
Fax
(918) 623-0613
NPI assigned
Oct 25, 2006
Last updated
Feb 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brett Alan Wessel, DCNPI 1588748776
Title
Chiropractor President
Phone
(918) 623-0613

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3578 OK Primary

Addresses

Primary practice location

1003 W Broadway
Okemah, OK 74859

Mailing address

1003 W Broadway
Okemah, OK 74859
Phone (918) 623-0613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040320000489 OK Part B Supplier - Clinic/Group Practice 0840181913 Receives reassigned benefits from 2 practitioners
Practice locations: Okemah, OK

National Provider Directory

National Provider Directory

Locations

1003 W Broadway St
Okemah, OK 74859
Phone (918) 623-0613

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393372800000",
    "number": "1003990185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W BROADWAY",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "74859",
            "telephone_number": "918-623-0613",
            "fax_number": "918-623-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W BROADWAY",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "74859",
            "telephone_number": "918-623-0613",
            "fax_number": "918-623-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKEMAH CHIROPRACTIC CLINIC INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-02-26",
        "status": "A",
        "authorized_official_last_name": "WESSEL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CHIROPRACTOR PRESIDENT",
        "authorized_official_telephone_number": "918-623-0613",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.